SCN5A Variant D1819N Detail

We estimate the penetrance of LQTS for SCN5A D1819N around 2% and the Brugada syndrome penetrance around 1%. SCN5A D1819N was found in a total of 72 carriers in 4 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. D1819N is present in 71 alleles in gnomAD. D1819N has been functionally characterized in 5 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Non_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A D1819N around 2% (1/82) and the Brugada syndrome penetrance around 1% (1/82).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.9 0.919 -0.1 0.729 6 3
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance Density is our previously published method to calculate the average BrS/LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT3 BrS1 Other Other Disease
22685113 2012 1 0 0 1 AF
24144883 2014 1 0 0 1 AF
16922724 2006 1 1 0 0
29325976 2018 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 72 71 1 0 -
VARIANT FEATURES ALONE: - 15 14 0 1 - -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

Functional Data

Peak and late/persistent current are relative to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype.
PubMed ID Year Cell Type Peak Current (%WT) V1/2 Act. (mV) V1/2 Inact. (mV) Late/Persistent Current (%WT)
22685113 2012 HEK 71 0.13 0.2
24144883 2014
16922724 2006
25904541 2015 HEK 76 -2 -1 88
29325976 2018

D1819N has 37 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
1814 10
1794 12
1853 14 I1853V,
1828 5 A1828S, A1828T,
1834 12 S1834R,
1813 11
1818 5
1833 14 I1833M,
1801 11
1824 12 P1824A,
1838 15
1832 12 Q1832E,
1820 4 A1820V, A1820T,
1811 14 Y1811X, Y1811N,
1860 13 c.5577_5578dupAA,
1857 11
1812 13 S1812X, S1812L,
1829 5
1835 11 L1835F,
1819 0 D1819N,
1821 6
1815 6
1798 14 W1798X,
1826 6 R1826C, R1826H,
1825 10 L1825P,
1797 10 I1797V,
1800 13
1793 13 M1793K,
1817 7
1827 6
1796 15
1823 10 E1823K, p.E1823HfsX10,
1816 6 D1816N, c.5445_5446insT, D1816E,
1831 8
1809 14 I1809M,
1830 9
1822 9 c.5464_5467delTCTG, c.5464-5467delTCTG,